Missile embolus of the portal vein

A missile embolus, an extremely rare lesion, presents an unusual and challenging problem for the clinician. A case is discussed in which a patient sustained a gunshot wound of the portal vein, and the bullet entered the portal venous system and then lodged in the superior mesenteric vein. The portal vein injury was repaired. The missile then migrated into the right branch of the portal vein and was not extracted. The patient recovered. This appears to be the first reported case of a missile embolus of the portal venous system.